NT-proBNP Changes in Patients with Ascites during Large Volume Paracentesis

Area of Science:

• Cardiology
• Hepatology
• Oncology

Background:

• N-terminal probrain natriuretic peptide (NT-proBNP) regulates cardiovascular homeostasis.
• Serum NT-proBNP changes during large volume paracentesis (LVP) in ascites patients were previously unexamined.
• Ascites management often involves LVP, impacting fluid balance and cardiovascular markers.

Purpose of the Study:

• To investigate serum NT-proBNP level changes during LVP in patients with ascites.
• To identify clinical correlates associated with NT-proBNP variations in cirrhotic patients undergoing LVP.
• To compare NT-proBNP responses between cirrhotic and malignancy-related ascites during LVP.

Main Methods:

• Prospective recruitment of 45 ascites patients.
• Measurement of serum NT-proBNP, biochemistry, and hemodynamics at baseline and during/after LVP.
• Analysis of 34 patients (19 cirrhosis, 15 malignancy).

Main Results:

• In cirrhotic patients, NT-proBNP decreased significantly post-LVP (77.3 pg/mL at 2L, 94.3 pg/mL at completion).
• In cancer patients, NT-proBNP showed a slight increase during LVP (10.5 pg/mL at 2L, 77.2 pg/mL at completion).
• Comorbid congestive cardiac failure (CCF) was the sole independent predictor of significant NT-proBNP reduction in cirrhotic patients (P < 0.01).
• No significant hemodynamic or renal biochemistry changes were observed in either group.

Conclusions:

• LVP is associated with significant serum NT-proBNP reductions in cirrhosis patients, but not in malignancy patients.
• Comorbid congestive cardiac failure is a key predictor of NT-proBNP changes during LVP in cirrhotic patients.
• These findings highlight distinct cardiovascular marker responses to LVP based on ascites etiology.